AB169,37
10Section 37
. 447.06 (1) of the statutes is amended to read:
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447.06
(1) No contract of employment entered into between a dentist
or dental
12therapist and any other party under which the dentist
or dental therapist renders
13dental services may require the dentist
or dental therapist to act in a manner
which 14that violates the professional standards for dentistry
or dental therapy set forth in
15this chapter. Nothing in this subsection limits the ability of the other party to control
16the operation of the dental practice in a manner in accordance with the professional
17standards for dentistry
or dental therapy set forth in this chapter.
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18Section 38
. 447.06 (1m) of the statutes is created to read:
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447.06
(1m) No contract of employment entered into between a dental
20therapist and any other party under which the dental therapist is employed to
21practice dental therapy may require a dental therapist to meet a minimum quota for
22the number of patients seen or the number of procedures performed.
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23Section 39
. 447.06 (2) (a) 3. of the statutes is amended to read:
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447.06
(2) (a) 3. For a school for the education of dentists
, dental therapists, 25or dental hygienists.
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1Section
40. 447.06 (2) (b) of the statutes is amended to read:
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447.06
(2) (b) A dental hygienist may practice dental hygiene or perform
3remediable procedures under par. (a) 1. only as authorized by a dentist
or dental
4therapist who is licensed to practice dentistry
or dental therapy under this chapter
5and who is present in the facility in which those practices or procedures are
6performed, except as provided in par. (c).
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7Section 41
. 447.06 (2) (c) (intro.) of the statutes is amended to read:
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447.06
(2) (c) (intro.) A dental hygienist may practice dental hygiene or perform
9remediable procedures under par. (a) 1. if a dentist
or dental therapist who is licensed
10to practice dentistry
or dental therapy under this chapter is not present in the facility
11in which those practices or procedures are performed only if all of the following
12conditions are met:
AB169,42
13Section 42
. 447.06 (2) (c) 2. (intro.) of the statutes is amended to read:
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447.06
(2) (c) 2. (intro.) The dentist
or dental therapist who made the written
15or oral prescription has examined the patient at least once during the 12-month
16period immediately preceding:
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17Section 43
. 447.06 (3) of the statutes is created to read:
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447.06
(3) (a) In this subsection:
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1. “Collaborative management agreement” means an agreement under par. (d).
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2. “Dental health shortage area” has the meaning given in s. 36.60 (1) (ad).
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3. “Direct supervision” means that the dentist is present in the dental office or
22other practice setting, personally diagnoses the condition to be treated, personally
23authorizes each procedure, and before dismissal of the patient, evaluates the
24performance of the allied dental personnel.
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14. “General supervision” means that the dentist is not present in the dental
2office or other practice setting or on the premises at the time tasks or procedures are
3being performed by the dental therapist, but that the tasks or procedures performed
4by the dental therapist are being performed with the prior knowledge and consent
5of the dentist.
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5. “Indirect supervision” means that the dentist is present in the dental office
7or other practice setting, authorizes each procedure, and remains in the office while
8the procedures are being performed by the allied dental personnel.
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6. “Medical Assistance patient” means a patient who is a recipient of services
10under the Medical Assistance program under subch. IV of ch. 49.
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7. “Qualifying dentist” means a dentist who is licensed in this state and who
12is actively practicing in this state.
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8. “Uninsured patient” means a patient who lacks dental health coverage,
14either through a public health care program or private insurance, and has an annual
15gross family income equal to or less than 200 percent of the federal poverty
16guidelines.
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(b) The scope of practice of a dental therapist shall, subject to the terms of a
18collaborative management agreement, be limited to providing the following services,
19treatments, and procedures:
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1. Oral evaluation and assessment of dental disease and formulation of an
21individualized treatment plan.
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2. Identification of oral and systemic conditions requiring evaluation or
23treatment by dentists, physicians, or other health care providers and managing
24referrals.
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3. Comprehensive charting of the oral cavity.
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14. Oral health instruction and disease prevention education, including
2nutritional counseling and dietary analysis.
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5. Exposure and evaluation of radiographic images.
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6. Dental prophylaxis, including subgingival scaling and polishing procedures.
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7. Dispensing and administration via the oral or topical route of nonnarcotic
6analgesic, anti-inflammatory, and antibiotic medications as prescribed by a licensed
7health care provider.
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8. Application of topical preventive or prophylactic agents, including fluoride
9varnish, antimicrobial agents, caries arresting medicaments, and pit and fissure
10sealants.
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9. Pulp vitality testing.
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10. Application of desensitizing medications or resins.
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11. Fabrication of athletic mouth guards and soft occlusal guards.
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12. Changing of periodontal dressings.
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13. Administration of local anesthetic and nitrous oxide.
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14. Simple extraction of erupted primary teeth.
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15. Nonsurgical extraction of periodontally diseased permanent teeth with
18tooth mobility of +3 to +4 to the extent authorized in the dental therapist's
19collaborative management agreement, except for the extraction of a tooth that is
20unerupted, impacted, or fractured or that needs to be sectioned for removal.
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16. Emergency palliative treatment of dental pain limited to the procedures in
22this paragraph.
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17. Preparation and placement of direct restoration in primary and permanent
24teeth.
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18. Fabrication and placement of single-tooth temporary crowns.
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119. Preparation and placement of preformed crowns on primary teeth.
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20. Indirect and direct pulp capping on permanent teeth.
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21. Indirect pulp capping on primary teeth.
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22. Intraoral suture placement and removal.
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23. Minor adjustment and repair of removable prostheses.
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24. Placement and removal of space maintainers.
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25. Pulpotomy on primary teeth.
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26. Tooth reimplantation and stabilization.
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27. Recementing of a permanent crown.
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28. Any additional services, treatments, or procedures specified in the rules
11promulgated under s. 447.02 (1) (g).
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(bm) 1. Notwithstanding par. (b) 1. to 28., a dental therapist shall, except as
13provided in subd. 2., limit his or her practice of dental therapy to providing the
14services, treatments, and procedures covered by his or her dental therapy education
15program.
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2. If any service, treatment, or procedure under par. (b) 1. to 28. was not covered
17by a dental therapist's dental therapy education program, the dental therapist may
18provide that service, treatment, or procedure if the dental therapist has
19subsequently received additional dental therapy educational training to provide
20that service, treatment, or procedure.
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(c) 1. Except as provided in subd. 2., a dental therapist licensed under this
22chapter may provide dental therapy services in this state only under the direct
23supervision or indirect supervision of a qualifying dentist with whom the dental
24therapist has entered into a collaborative management agreement.
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12. a. Once a dental therapist licensed under this chapter has provided dental
2therapy services for at least 2,000 hours under direct supervision or indirect
3supervision, the dental therapist may provide dental therapy services in this state
4under the general supervision of a qualifying dentist with whom the dental therapist
5has entered into a collaborative management agreement.
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b. For purposes of the 2,000 hours requirement under subd. 2. a., hours may
7include hours of providing dental therapy services in this state under direct
8supervision or indirect supervision of a qualifying dentist as described in subd. 1. or
9hours of providing dental therapy services under direct supervision or indirect
10supervision while licensed as a dental therapist outside this state, but may not
11include any hours completed prior to graduating from the dental therapy education
12program.
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3. Notwithstanding subds. 1. and 2., the level of supervision for a dental
14therapist may be further limited under the terms of a collaborative management
15agreement under par. (d) 1. b.
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4. A supervising dentist shall accept responsibility for all services performed
17by a dental therapist pursuant to a collaborative management agreement. If services
18needed by a patient are beyond the dental therapist's scope of practice or
19authorization under the collaborative management agreement, the dental therapist
20shall, to the extent required under the collaborative management agreement,
21consult with the supervising dentist as needed to arrange for those services to be
22provided by a dentist or another qualified health care provider.
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(d) 1. Prior to providing any dental therapy services, a dental therapist shall
24enter into a written collaborative management agreement with a qualifying dentist
1who will serve as a supervising dentist under par. (c). The agreement must be signed
2by the dental therapist and the qualifying dentist and address all of the following:
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a. The practice settings where services may be provided and the patient
4populations that may be served.
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b. Consistent with and subject to pars. (bm) and (c), any conditions or
6limitations on the services that may be provided by the dental therapist, the level of
7supervision required, and any circumstances requiring consultation prior to
8performing services.
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c. Age-specific and procedure-specific practice protocols.
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d. Dental record-keeping procedures.
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e. Plans for managing dental or medical emergencies.
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f. A quality assurance plan for monitoring care provided by the dental
13therapist.
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g. Protocols for administering and dispensing medications.
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h. Criteria or protocols relating to the provision of care to patients with specific
16medical conditions, treatments, or medications.
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i. Policies relating to supervision of dental hygienists and other staff.
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j. A plan for the referral of patients to other dental or health care providers or
19clinics when services needed are beyond the scope of practice or authorization of the
20dental therapist.
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k. Whether and to what extent the dental therapist may perform services
22described in par. (b) 15.
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2. a. A collaborative management agreement shall be limited to covering one
24qualifying dentist and one dental therapist.
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1b. A dental therapist may enter into multiple collaborative management
2agreements.
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c. No dentist may have collaborative management agreements with more than
44 dental therapists at any time.
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(e) A dental therapist shall at all times comply with at least one of the following:
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1. Limit his or her practice to practicing in one or more dental health shortage
7areas. If a dental therapist begins practicing in a dental health shortage area, and
8that area loses its designation as a dental health shortage area while the dental
9therapist continues to practice in that area, the dental therapist is considered to
10satisfy this subdivision as long as the dental therapist continues to practice in that
11area.
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2. Practice in one or more settings in which at least 50 percent of the total
13patient base of the dental therapist consists of patients who are any of the following:
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a. Medical Assistance patients.
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b. Uninsured patients.
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c. Patients receiving dental care at free and charitable clinics.
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d. Patients receiving dental care at federally qualified health centers.
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e. Patients who reside in long-term care facilities.
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f. Veterans.
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g. Patients who are members of a federally recognized Indian tribe or band.
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h. Patients receiving dental care at clinics or facilities located on tribal lands.
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i. Patients with medical disabilities or chronic conditions that create barriers
23of access to dental care.
AB169,44
24Section
44. 447.063 of the statutes is amended to read:
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1447.063 Preservation and transfer of patient health care records. (1) 2A person who manages or controls a business that offers dental
, dental therapy, or
3dental hygiene services, including management or control of a business through
4which the person allows another person to offer dental
, dental therapy, or dental
5hygiene services, shall preserve patient health care records, as defined in s. 146.81
6(4), for an amount of time determined by the examining board by rule.
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7(2) A person who manages or controls a business that offers dental
, dental
8therapy, or dental hygiene services, including management or control of a business
9through which the person allows another person to offer dental
, dental therapy, or
10dental hygiene services, shall, upon request of a patient or person authorized by the
11patient, as defined in s. 146.81 (5), transfer the patient health care records, as
12defined in s. 146.81 (4), of the patient to another person that the patient or person
13authorized by the patient specifies to receive the patient health care records.
AB169,45
14Section 45
. 447.065 of the statutes is amended to read: